HomeMy WebLinkAboutZ-5980FORM NO. t
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y,
Certificnte Of Occupnncy
No. ZE980 ...... Date ............ ,Iurte..27 ...... , 19.7.~.
THIS CERTIFIES that the building located at0rohar, d. Slx. eel; ............ Street
Map No. ~ ........ Block No..~ ..... Lot No. ~ .... 0ri. e~.. ~.. ...........
~ f 1 ~el · ou in code
conforms substantially to the ~~~ ~,,~ g,~.,~[.,,~.:..
dated ......... J~e.. 2~ ..... , 1~..~, was issued, and conforms to ah of the req~re-
ments of the applicable provisions of the law. The occupancy for which this certificate
issued is · 'Private. one- f~ily. ~wetl~..& acceasor~ .building ............
The certificate is issued to . V$=g!~la. ~ste~ ....... ~e= ......................
(owner, lessee or ten~t)
of the aforesaid building.
Suffolk County Department of Health Approve . .pree~.~s~.~g
UNDERWRITERS CERTIFICATE No. prec. ~ls~.~g.
HOUSE NUMBER ..... 1 ~ .... Street ....... Orchard. S~ .......................
B~ld~g Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in DUpLICAtE to the Building
Inspector with the following; for new buildings or new use: '
1. Final survey of property with accurate location of all buildings, property lines, streets, and
unusual natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multipie Residences and similar buildings and
installations, a certificate of Code compliance from the Architect or Engineer responsible for
the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property lines, streets, buildings and unusual natural
or topographic features.
2. Sworn statement of owner or previous owner os to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in-
formation required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
~ 2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date ....Jllna.12 ..... 19.7..4. ............
New Building ................ Addition ................ Old or Pre-existing Building .... .O-.1.-.d.....l~acant Land ..............
Location Of Property .zNo. r~h ,sj.~l,~ .o.~f 0.~.h~.rd St. with house numbered 1045 Orchard
Street .............................................................................................
Owner Or Owners Of Prooertv .V.~,.r.~g±n±a F. Rosteck by. ±nher±tance from parents EDWARD
L. FROST and HELEN G. ~R~)'g~'~' ~'6%~'"d~'~'d ...................................................................
Subdivision ..... t~o~e ................................................. Lot No...n...o..n..e... Block No_ none No 1045
N x Schreier, E x Schreier, S x Orchard St., W x Carl'~b'fi" House .............
Permit ~o .... 9. .......... Date Of Permit ........ ..9. .......... Applicant ?
?
Hea[th Dept. Approval ........ .9.. .................................. Lobar Dept. Approval ..... : ..........................................
Underwriters Approval
.......... : ................................... Planning Board Approval
Request For Temporary Certificate
..... : .................................. Final Certificate
Fee Submitted $ .~..0.0 ..........................
Constructiononabovedescribedbuildinga~_~rmitmeets~ll~/~a,~blecod/~and regulations.
Sworn ,i~y'before me this Z//~tco,,~rey ~or VIRGINIA 'F .//g~STECK
~"~'..(~-~... dayof ~l'~...e, 197/4 · ~'~'~
.................................... ~stamp or seflll)
Notary Public .................................... County ~), c~' ~-~'~'
AFFIDAVIT FOR
CERTIFICATE OF OCCUPANCY
ON STRUCTURES
at 1045 Orchard Street
STATE OF NEW YORK )
)SS.:
COUNTY OF ONONDAGA)
VIRGINIA F. ROSTECK, being duly sworn, deposes and says~
that she resides at Lakeview Grove, Constantia, New York,
and is the present owner of property at Orient, Town of
Southold, Suffolk County, New York, consisting of a nearly
rectangular parcel of land fronting 80 feet on the northerly
side of Orchard Street about 246 feet deep on the westerly
side, 255.27 feet deep on the easterly side, and 80.00 feet
across the rear.
Deponent states that she became the owner of said prop-
erty from the will of her mother, HELEN G. FROST, who died
a resident of Orient, Suffolk County, New York, on April 4,
1974, leaving a will admitted to probate in the Surrogate's
Court therein under which she was devised said property as
part of the residuary estate.
Deponent states that she recalls her parents EDWARD L.
FROST and HELEN G. FROST purchasing said property in 1941
by deed of Ruberta Young Tabor and another dated July 12,
1941. Deponent recalls that the building and barn now on
the property were at the same location at the time of such
purchase and that deponent moved into such property with her
parents at that time. Deponent knows that the buildings
then on the land, although improved, were not demolished or
replaced.
Deponent believes that the annexed map drawn January 3,
1974, by RODERICK VAN TUYL, INC. correctly shows the boundary
of the property but not the buildings erected thereon. Such
map was prepared at the request of deponents mother in con-
nection with a proposed transaction involving the rear line
but not the buildings thereon.
Deponent knows of no housing code or safety inspection
of the building or premises, any unusual natural or topo-
graphical features, or other matter to be brought to the
attention of the Building Inspector necessary for prepara-
tion of a certificate that the buildings thereon, having
been placed on the property before 1957.
Deponent states that she knows of no presently existing
survey which might show the location on the property of the
buildings referred to above presently known as 1045 Orchard
Street.
Deponent requests that a certificate be issued certi-
fying that the buildings on said premises are legally ex-
isting non-conforming uses if not presently conforming to
the ordinances of the Town of Southold.
· ~ini~ . Rosteck ~
Sworn to before me this
~da~ of June, 1974.
Notary Public
"0" ., ?'?I'TTA~-N
,ic t ~ Stale of N~w
;,oalilie~ m 0,'~o.. 6o. ~o. 34-042332~ .~
M;f rom .;: 'sio. ~pire~ March 3~, 1935'
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